Healthcare Evidence for EU Citizens Living in Spain

The certificado de registro and the three-month rule

An EU citizen can stay in Spain for up to three months without registering. If you are staying longer, Spain's rules for EU citizens, Real Decreto 240/2007, require you to apply for inclusion in the Registro Central de Extranjeros (Central Register of Foreign Nationals) "en el plazo de tres meses contados desde la fecha de entrada en España" (within three months of entering Spain) (BOE). The result is the certificado de registro de ciudadano de la Unión, the green certificate or card that carries your NIE.

The same rules apply to citizens of Iceland, Liechtenstein, Norway and Switzerland. The application fee is paid with form 790 code 012; Taxdown lists it at €12 for 2026 (Taxdown), but confirm the current amount on the payment form.

What you have to prove at the appointment depends on which category you register under.

What each category must show

Article 7.1 of Real Decreto 240/2007, which transposes article 7 of Directive 2004/38/EC, sets out four bases for residence. The official information sheet for the certificate, based on Orden PRE/1490/2012, lists the evidence for each (hoja informativa):

Family members register on the basis of the EU citizen they accompany, who must meet one of these conditions.

The important point is the first two rows. If you are working in Spain, your Social Security registration does the work and you do not need to buy insurance for the certificate. Once registered, you get public healthcare through your contributions. See public healthcare for workers and autónomos.

Sufficient resources: no fixed figure

People registering as non-workers often ask how much money they need. The legal answer is that Spain cannot set a fixed sum. Article 7.7 of Real Decreto 240/2007 says "no podrá establecerse un importe fijo" (no fixed amount may be set), and the amount demanded cannot be higher than the level at which Spanish nationals become entitled to social assistance, or the minimum Social Security pension. Article 8(4) of the Directive says the same and adds that your personal situation must be taken into account.

You can prove resources by any lawful means: bank certificates showing your available balance, pension statements, property titles and similar. In practice, bring a recent bank certificate and proof of regular income such as a pension.

Which health evidence is accepted

The rule for non-workers is that the insurance can be "público o privado, contratado en España o en otro país" (public or private, taken out in Spain or in another country), provided it gives cover in Spain during your residence equivalent to the Sistema Nacional de Salud (national health system). That leaves you four realistic options.

1. An S1 from your pension state

If you receive a state pension from another EU country and none from Spain, that country normally remains responsible for your healthcare. The information sheet says pensioners meet the condition with a certificate showing their healthcare is covered by the state paying the pension. In practice that is the S1, which you register with the INSS (Spain's Social Security institute) to get a Spanish health card. Our guide to registering an S1 walks through the process.

2. A Spanish private policy

A policy from a Spanish insurer such as Sanitas, DKV, SegurCaixa Adeslas, ASISA or Mapfre is the simplest evidence because the registration office can read it and the cover is obviously in Spain. Choose a comprehensive policy that includes hospitalisation. The rule asks for cover equivalent to the public system; it does not explicitly mention co-payments, but a policy without co-payments (sin copago) and with a full hospital benefit gives the office no reason to question equivalence. Our residency insurance requirements page compares what different routes ask for.

3. A policy from another country

A policy bought in Germany, the Netherlands or elsewhere is allowed if it covers you in Spain for the whole period to an equivalent standard. Get a certificate from the insurer, ideally in Spanish, stating that you are covered for residence in Spain, the start and end dates, and that cover includes primary care, specialists and hospital treatment.

4. An EHIC (students only)

A European Health Insurance Card is accepted for students if it is valid for the whole period of residence. It is not listed as acceptable evidence for retired or self-sufficient non-workers, because it is designed for temporary stays. See EHIC, GHIC and residence healthcare.

After you register

Registration is not the same as public healthcare. Workers and S1 holders still need to register with the regional health service for a tarjeta sanitaria (health card); see how to get a Spanish health card.

Non-workers relying on private insurance have one public option later. After at least one continuous year of residence, with a current padrón (town-hall registration) and no public cover through any other route, you can apply for the convenio especial. It costs €60 a month under 65 and €157 from 65, and you pay the full price of outpatient prescriptions (Ministerio de Sanidad). The Ministry asks EU citizens for a declaration or certificate that they have no access to public healthcare in their home country.

After five years of continuous legal residence you acquire the right of permanent residence, which under Article 16 of the Directive is no longer subject to the sufficient-resources and insurance conditions (Your Europe).